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Prepublished online as a Blood First Edition Paper on April 17, 2003; DOI 10.1182/blood-2003-01-0223.

Submitted January 24, 2003
Accepted April 6, 2003
Erythropoietin is a potent physiological stimulus for endothelial progenitor cell mobilization
Christopher Heeschen, Alexandra Aicher, Ralf Lehmann, Stephan Fichtlscherer, Mariuca Vasa, Carmen Urbich, Christiane Mildner-Rihm, Hans Martin, Andreas M Zeiher, and Stefanie Dimmeler*
Molecular Cardiology, Department of Internal Medicine IV, University of Frankfurt, Frankfurt, Germany
Hematology, Department of Internal Medicine III, University of Frankfurt, Frankfurt, Germany
* Corresponding author; email: dimmeler{at}em.uni-frankfurt.de.
Increasing evidence suggests that postnatal neovascularization involves the recruitment of circulating endothelial progenitor cells (EPC). Hematopoietic and endothelial cell lineages share common progenitors. Cytokines formerly thought to be specific for the hematopoietic system have only recently been shown to affect several functions in endothelial cells. Accordingly, we investigated the stimulatory potential of erythropoietin (Epo) on EPC mobilization and neovascularization. The bone marrow of Epo-treated mice showed a significant increase in number and proliferation of stem and progenitor cells as well as in colony forming units. The number of isolated EPCs and CD34+/flk-1+ precursor cells was significantly increased in spleen and peripheral blood of Epo-treated mice compared to PBS-treated mice. In in vivo models of postnatal neovascularization, Epo significantly increased inflammation- and ischemia-induced neovascularization. The physiological relevance of these findings was investigated in patients with coronary heart disease. In a multivariate regression model, serum levels of Epo and vascular endothelial growth factor were significantly associated with the number of stem and progenitor cells in the bone marrow as well as with the number and function of circulating EPC. In conclusion, the present study suggests that Epo stimulates postnatal neovascularization at least in part by enhancing EPC mobilization from the bone marrow. Epo appears to physiologically regulate EPC mobilization in patients with ischemic heart disease. Thus, Epo serum levels may help identifying patients with impaired EPC recruitment capacity.

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A. Hirata, T. Minamino, H. Asanuma, M. Fujita, M. Wakeno, M. Myoishi, O. Tsukamoto, K.-i. Okada, H. Koyama, K. Komamura, et al.
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P. van der Meer and E. Lipsic
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D. Patschan, K. Krupincza, S. Patschan, Z. Zhang, C. Hamby, and M. S. Goligorsky
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L. Zentilin, S. Tafuro, S. Zacchigna, N. Arsic, L. Pattarini, M. Sinigaglia, and M. Giacca
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M. E.J. Reinders, T. J. Rabelink, and D. M. Briscoe
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K. Satoh, Y. Kagaya, M. Nakano, Y. Ito, J. Ohta, H. Tada, A. Karibe, N. Minegishi, N. Suzuki, M. Yamamoto, et al.
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N. Werner and G. Nickenig
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J. Muller-Ehmsen, A. Schmidt, B. Krausgrill, R. H. G. Schwinger, and W. Bloch
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H. Tan, X. Jiang, F. Yang, Z. Li, D. Liao, J. Trial, M. J. Magera, W. Durante, X. Yang, and H. Wang
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P Van der Meer, E Lipsic, R. Henning, K Boddeus, J van der Velden, A. Voors, D. van Veldhuisen, W. van Gilst, R. Schoemaker, J. Leemans, et al.
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H. Zhang, A. Zhang, D.E. Kohan, R.D. Nelson, F.J. Gonzales, T. Yang, C. Schmidt-Lucke, L. Rossig, S. Fichtlscherer, M. Vasa, et al.
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J. George, E. Goldstein, A. Abashidze, D. Wexler, S. Hamed, H. Shmilovich, V. Deutsch, H. Miller, G. Keren, and A. Roth
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C. T. Chan, S. H. Li, and S. Verma
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P. van der Meer, E. Lipsic, R. H. Henning, K. Boddeus, J. van der Velden, A. A. Voors, D. J. van Veldhuisen, W. H. van Gilst, and R. G. Schoemaker
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V. J. Dzau, M. Gnecchi, A. S. Pachori, F. Morello, and L. G. Melo
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S. Namiuchi, Y. Kagaya, J. Ohta, N. Shiba, M. Sugi, M. Oikawa, H. Kunii, H. Yamao, N. Komatsu, M. Yui, et al.
High Serum Erythropoietin Level Is Associated With Smaller Infarct Size in Patients With Acute Myocardial Infarction Who Undergo Successful Primary Percutaneous Coronary Intervention
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M. Scortegagna, K. Ding, Q. Zhang, Y. Oktay, M. J. Bennett, M. Bennett, J. M. Shelton, J. A. Richardson, O. Moe, and J. A. Garcia
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F. Andreotti and R. C. Becker
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P. M. Humpert, R. Neuwirth, M. J. Battista, O. Voronko, M. von Eynatten, I. Konrade, G. Rudofsky Jr, T. Wendt, A. Hamann, M. Morcos, et al.
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F. H. Bahlmann, K. de Groot, O. Mueller, B. Hertel, H. Haller, and D. Fliser
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A. Aicher, A. M. Zeiher, and S. Dimmeler
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J. Grisar, D. Aletaha, C. W. Steiner, T. Kapral, S. Steiner, D. Seidinger, G. Weigel, I. Schwarzinger, W. Wolozcszuk, G. Steiner, et al.
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D. J. Manalo, A. Rowan, T. Lavoie, L. Natarajan, B. D. Kelly, S. Q. Ye, J. G. N. Garcia, and G. L. Semenza
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K. Maiese, F. Li, and Z. Z. Chong
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